Evidence Of Caring

The job of sexual assault forensic nurses like Mercy's Joyce Faust is getting the grim facts, but also beginning to mend a victim's broken trust

A Day In The Life

November 18, 2003|By Linell Smith | Linell Smith,SUN STAFF

On television, sexual-assault forensics is a fast-paced, dramatic world of science that sometimes intersects with high-profile, real-life cases such as those involving Jessica Lynch, Kobe Bryant and Elizabeth Smart. It's a place of lurid crimes, startling breakthroughs and quick convictions.

The reality of the profession, however, is messy, complicated and often painfully slow, says forensic nurse Joyce Faust. It's filling out forms and redirecting paperwork. It's remaining receptive and unbiased for a never-ending procession of victims, some of whom you've seen before. It's receiving daily reminders of the grim details of inhumanity.

Yet the Mercy Medical Center nurse feels proud that she has an opportunity to make a difference in the lives of women who have been sexually assaulted. She knows the hours she spends with each victim may prove crucial to determining how she ultimately recovers.

During her three years with the Sexual Assault Forensic Examiner (SAFE) program, Faust has collected criminal evidence from teen-agers gang-raped by schoolmates and from elderly women assaulted in nursing homes. She has examined homeless women, drug abusers and victims of domestic violence. She's seen college students assaulted after being drugged at parties. She remains haunted by the fear and confusion of a woman who was raped repeatedly by her own son.

She tries, however, not to let these experiences affect her judgment. The first lesson for a sexual assault forensics examiner, she says, is to become aware of your prejudices - then try to abandon them. To be effective, you must be as objective as possible. The nature of her business is that you may take evidence from a rape victim one day and collect similar material from her alleged assailant on the next.

"I don't want to say that we come into the examination with blinders, but we have a specific interview process," she says. "I do every exam as if I were going to court the next day. I've got to be thinking like a nurse, but I also have to be thinking as if there were a prosecuting attorney and a defense attorney standing behind me."

"What's hardest to adjust to is your own preconceived notions of what somebody who was raped should look like," she says. "Should they be curled up in a fetal position barely able to meet your gaze? What about the person who's on her cell phone [in the examining room] laughing, cutting up, acting like it's just another visit to a [gynecologist]?

"You see a very broad range of people. You can't be dismissive of anyone because you don't know where they are on the continuum of stress reactions."

The Mercy forensic staff handles all sexual assault cases in Baltimore. The hospital is also temporarily handling all the cases from Baltimore County. Specially trained and certified nurses on staff and on call see an average of 30 victims each month. They also visit other hospitals if assault victims are too injured to be moved.

Sometimes Faust sees women shortly after they were attacked. Many will wait two or three days, however, before going to a hospital or reporting the crime to police.

One patient at a time

After police officers determine there is reason to collect evidence, they send a victim to Mercy Medical Center's SAFE program so forensic nurses can examine her entire body and clothes, taking any physical material that might be used to identify and prosecute her attacker.

"This is hot, stinky, smelly, nasty work," Faust says. "It's not something you do for the pat on the back. I do this work to help somebody. And I also do it because I can help one patient at a time. When you're a nurse in the ER, you've got four or five people there, and you've got another 30 out in the waiting room. You do what you can for them, but it's not the values of old-time medicine."

Plain-spoken and respectful, Faust begins an examination by asking each woman what happened, adding questions about aspects of the attack that might lead her to collect evidence from an overlooked part of the body. She also takes photographs and marks notes about cuts and bruises on drawings of the head and body. Using a tiny, high-tech camera, she records the condition of each woman's genital area, taking cotton swab samples from the vagina and cervix to test for an attacker's DNA, for trace semen and for sexually transmitted diseases.

After a thorough interview, examination and appropriate medical testing, Faust offers a client an antibiotic to ward off any STD to which she might have been exposed, as well as an emergency contraceptive that complies with the ethical and religious directives for Catholic health care services.